CMS Price Transparency Data
Tdap vaccine (tetanus, diphtheria, pertussis)
Facility: Adventist Health Castle
Billing Code: 90715 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90715
- Insurance Median: $67
- Cash Discount Price: $26
- vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Adventist Health Castle is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.
Cash / Self-Pay
$26
Average discount available for prompt cash payment at this facility.
Insurance Median
$67
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
N/A
Standard federal government reimbursement rate for this code.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $4 | N/A |
| Alohacare Quest McAid - All Other Plans | $9 - $54 | N/A |
| Pacific Admin PPO - All Plans | $24 - $138 | N/A |
| Hwmg/Hmaa - All Plans | $28 - $159 | N/A |
| Mdx Hawaii PPO - All Plans | $30 - $173 | N/A |
| Health Alliance - All Plans | $30 - $173 | N/A |
| Kfh - All Other Plans | $32 - $184 | N/A |
| Uni Health Alliance - All Plans | $35 - $202 | N/A |
| First Health PPO - All Plans | $36 - $204 | N/A |
| Medicaid / KanCare | $38 - $217 | N/A |
| State of Hi Nonprofit - All Plans | $66 - $379 | N/A |